Developing countries with fast growing, young populations and high unemployment, have different priorities from other countries.

Africa, for example, is not trying to solve the same problems the west is trying to solve.

As the world hurtles, brakes off, into the wild, uncharted abyss of artificial intelligence, Africa appears to be letting itself get dragged along.

The same way we were passive bystanders in previous Industrial Revolutions.

Our reaction is to mimic every step. Hold our own AI talk shops.

But, must we copy everything? Does everything that is designed by others, for others, also serve us?

2 Think first

Think. Original thought is the first law of Artificial Intelligence. If we don’t have our own plans or ideas, AI will work against us. The same way previous industrial revolutions profited the west, while still exploiting global south resources.

Why on earth do we expect this time to be different? What on earth are we doing differently?

We have come a long way from the beginning of time, when different cultures across Africa used original intelligence to solve problems. We are now swept up in a modern phenomenon where intelligence is being used to create brand new problems.

Tell me. Who needs unemployment?

Who needs the new dystopian future, the alarmist scenarios precipitated by headless, heedless threats of “the looming singularity”? And, who even decides these sorts of bizarre destinations, on our behalf?

3 Our AI

Artificial intelligence is often described as unprecedented, and fully western. But indigenous African knowledge systems pioneered its underlying logic.

Binary code.

Probabilistic reasoning.

Decision-making mathematical models.

Boolean algebra.

Memory computation.

Ifá, a Yoruba knowledge corpus has used binary code to generate predictive insights for over 8,000 years. Researchers like Olu Longe & Ron Eglash have traced a conceptual lineage from African binary systems through Arab geomancy and European alchemy to the work of Gottfried Leibniz, the 17th-century mathematician nowadays credited with formalising binary logic.

But, the version of predictive and generative intelligence made by the west has a different trajectory from all its predecessors. A devastating future event called the Singularity is predicted to be around the corner. Some say we are already in it.

It is the barely perceptible moment when machines surpass human intelligence and no longer need to be told what to do. When this point is reached, it will upend human life as we know it, causing rapid, uncontrollable, and irreversible changes to civilization.

Easy to predict: secretary type jobs, analytical roles or even manual labor, will disappear. Isn’t that 90% of what constitutes modern work? Those of us in healthcare jobs are told to prepare for a future where we are no longer the apex professionals, as we have been for hundreds of years.

This is where I differ.

4 Culture of Care

Living in Europe for 2 decades and counting, I have observed their culture of medical practice. It is good in many ways, deleterious in a few.

As a theoretical and clinical subject, there is nothing happening in western medicine that is not happening in the hospitals and medical schools where I was trained in Africa, sometimes even better. Western medicine does have a definite technological and research edge. But this is nothing better distribution of capital cannot solve. There is certainly not an innate human superiority in western medicine, despite centuries of fallacious race science and global health propaganda.

My point is, the arts of medicine and nursing, as practiced in the west, are slightly different, in the cultural context, from the more classical, more clinically oriented, more hands on, much more interpersonal healthcare culture in countries like Nigeria or Ghana.

And, I hope things stay that way.

I am alarmed that a time comes when African nurses and doctors become as impersonal and secretary-like as those I’ve seen in Europe.

It appears inevitable, given the acceleration of capitalism’s pressures, and our shortages of staffing, and growing populations. Conditions that respond well to algorithmic resource management and time efficiency: and what does AI do, if not analytical and algorithmic work?

In this sense, AI will take over.

But, this kind of human-absent medical care is also why the breakdown of social, community and mental health is accelerating across the west.

5 Stand Your Ground

In an alternative scenario, where African health systems place more value on our own indigenous cultures of care, and reject the replacement of the human interface by machines and algorithms, the AI replacement will never happen.

Yes, parts of our job will be taken over.

The note taking, analysis, diagnoses and manual surgical parts.

But, is that what makes a doctor, or a nurse? I certainly hope not.

In a viral 2026 essay on the looming AI-pocalypse, titled “something big is happening”, Matt Shumer, predicts: “AI is now building AI…exceeding human performance in… medical analysis, reading scans, lab results, suggesting diagnoses, reviewing literature,”

Earlier this year, Anthropic CEO Dario Amodei prophesied “Within 1 to 5 years, AI could replace 50% of white-collar jobs. AI is coming for cognitive labor. All of it.”

He may be right. Except that real medicine is not just ‘cognitive labor’. It is emotional and human and physical, and most importantly, cultural. What works in the west as care, may actually exacerbate disease for someone raised with higher social standards and critical expectations regarding care.

However, when money is the chief metric for healthcare, and time is as scarce as it can be under capitalism, the stranglehold of AI on healthcare grows stronger.

That is why I’m calling for a medicine and nursing that upholds not just our Hippocratic commitment, but harks back to the traditions of Imhotep, Osanyin, and every Dibia, Sangoma, Babalawo and community nursing systems that predate the capitalist mode of medicine today.

Over the din of profit and privatization, can we choose to continue to prioritize models of care as human presence , connection and communication, over and above factory-floor modes of ‘efficiency’, time saving , and profits?

Or is that too much to ask?

6 Ideology of AI

These predicted AI singularity type outcomes will vary by culture.

Cultures where the human alternative is weak, such as the west, will go extinct.

Africa, where we function more on human-to-human connection should at least have more time to contemplate this path. I quote economist Jason Hickel when he says, “poor countries are poor because they are integrated into the global economic system on unequal terms, and aid only helps to hide this.” I quote this to point out that Africa is locked at the hip to the West, and this, not on terms favorable to us. And that, while the economic yoke is apparent, the forced mental colonialism is often debated.

Therefore, Africa’s professions, such as law, accounting, medicine, and so on, are all modeled as closely as possible to the west. In that way, we expect that whichever way the west goes, as far as technology adoption, Africa is bound to go. We will copy the ideas, but they will keep the profits. That’s the way the world has always been.

But must it be that way to the end? Why do we have a proverb about the fly that follows the deceased body into the grave? The west is going down fighting, and attempting to take everybody down with it – must we follow, or can we for the first time, outthink them, and center ourselves?

7 AI is Capitalism on Steroids

Important, if Africa and global south make the radical choice to decolonize and delink our Markets, policies and worldviews from Western led models, we might maybe escape the imposition of an AI dominant future.

The west developed AI to solve a problem they have, and as a strategy to build a future they are desperate for. AI’s ultimate goal is to defund, devalue and demonetize human labor.

Think of it as a historical progression from feudalism to slavery to colonization to neocolonialism and globalization and capitalism and finally artificial intelligence.

In each of these steps, labor is cheapened until the cost drops to zero and falls through the floor. Step by step, capital is accumulated completely until all of it belongs to the 1 percent at the top and the masses own nothing. Remember this is an actual quote popularized by that infamous gathering of untouchable elites, the World Economic Forum: “In the future you will own nothing and you will be happy”.

Capitalism was the beast that perfected this centuries long process, and AI is really just end stage capitalism.

No coincidence that AI coincides with the death throes of empire, unfolding in real time as Trump bares the imperial core’s true fangs, with tariffs and bombs going off ad nauseam.

The trick is to present AI as the ultimate technology when all it really is is the ultimate market tool, the ultimate capitalism, the veritable 5th Industrial Revolution.

As the 1st & 2nd revolutions were rooted in enslavement & colonization of the global south, especially Africa, the 3rd & 4th are based on dehumanization, illicit extraction and capital violence. This final Industrial Revolution will be at its heart, still unethical, immoral and antihuman.

8 AI for Good

Of course mainstream narratives will avoid this, and instead present AI as a technological revolution. History has always been best understood only in hindsight. But you don’t have to be like that. You can understand it before it happens. That’s why we study, and refuse to be drowned in matrix hoopla.

The coming implosion can hardly be resisted or controlled by individuals, but if the global south as a group, and in particular Africa as one collective, the source of the industrial minerals that power modern technology, can stand its ground, delink itself and unintegrate its economies and politics, from centuries-long exploitation and unequal positioning within the extractive global order, there’s a glimmer of a chance the west will die alone, and the rest of us will be saved from this latest Anthropocene, this end time extinction, this final apocalypse disguised as technological singularity.

Listen. All of this fatalism, the apocalyptic scenarios and human-deleting use cases of AI are by deliberate design. Other choices could’ve been made.

Instead of endless new wars, maybe AI for world peace?

Instead of homeless people on the streets of New York and Amsterdam, maybe affordable housing?

Instead of millions dying of curable and potentially eradicable diseases, maybe AI for good health?

What happened to our post-WWII mantra, Health for All?

AI could have solved not only the scientific basis, but also the governance necessary to distribute #UniversalHealthCoverage.

But we are here. In that other universe where nobody gives a fadoodle about who lives, or a floccinaucinihilipilification about who dies.

In spite of AI, our modern lives are infrequently mired in tight time schedules and daily traffic: the associated cortisol-spiked stress-related, chronic diseases cost the US economy $4.4 trillion, or (90%) of the nation’s total annual healthcare spending.

Think about it, instead of maddening traffic and overstretched, inefficient public transport, what about a new age of AI for fast and efficient public transportation systems?

Instead of eleventh-hour climate crisis, how about AI solutions to our various environmental catastrophes, all driven by unmitigated capitalism?

Do we need more war, and more digital spying, or on the other hand, maybe, the ability to have our needs met without spending all our time at work? How about care for the disabled and elderly?

But a system driven by the endless pursuit of profit only makes human life worse, AI or no.

AI could have served human needs on a global scale, at a faster rate than we’ve ever seen.

But, capitalism: the goal of which has never been to make anything better, but everything cheaper for the capitalist overlords.

So, AI will continue to fulfill all the most toxic traits of capitalism, but finally remove the last shreds of any possible accountability, as human interface is rendered redundant by the sovereign will of a very few super-elite, who will remain beyond the veil, and who will be exempt from total surrender and utter subjugation to the coming Anthropocene.

Sources

Fractals at the heart of African design

https://www.ted.com/talks/ron_eglash_the_fractals_at_the_heart_of_african_designs

Ifa & computer science

https://www.google.ca/books/edition/If%C3%A1_Divination_and_Computer_Science/u19dXwAACAAJ?hl=en&kptab=overview

AI & capitalism

https://x.com/caitoz/status/1982252101066731913?s=20

AI is now building the next AI

https://www.linkedin.com/pulse/something-big-happening-matt-shumer-so5he?utm_source=share&utm_medium=member_ios&utm_campaign=share_via

On the Risks of Powerful AI

https://www.darioamodei.com/essay/the-adolescence-of-technology

Now, in part 2 of What’s wrong with our idea of budgets?, we are going to show that our health budgets have never been about health.

What do we typically budget for?

WHAT on earth, specifically, are our health budgets for? We say they are for health, but, what is health, to a budgeter? Now if you’ve ever seen any budget in Nigeria, whether federal or state, you will know that for the past 60 years, every budget devotes 70% or more, to salaries and recurrent expenditure.

If our health budget follows that pattern, then health is going nowhere.

Health cannot be achieved by paying health workers. Now don’t get me wrong - these people have worked for their money. But paying salaries is not a health matter at all: it is properly a labor matter, period. It is also an economic matter.

Our health budgets must change their major line items from mostly salaries, to actual health issues: such as capital expenditure, institutional development, research, manufacturing, logistics & service delivery.

These are the ‘moving parts’ of our health systems. For now, who pays for these actual health system parts? Donors. And, even then, only in part. Meaning, these building blocks of health systems are mostly underfunded or unfunded. Can you see now why we have weak to no health systems? It’s not ‘corruption’: it’s that we are misbudgeting and mismanaging the basic idea of money and budgets. Maybe, we’ve never had to think about it?

Are we asking the right questions?

It’s not just in Nigeria or Africa: worldwide, there is no universally fixed “recommended” proportion of a country’s budget for recurrent vs capital expenditure. But, if we start to think for ourselves, we will recognize how uniquely important it can be, for countries at earlier stages of development to free up their budgets from vicious salary cycles. Start budgeting better so we can spend on productivity, capital, systems and institutions, and not just on perennial cycles of consumption and debt repayment.

Whatever questions need to be asked, whatever productivity-focused policy changes need to be acted upon, let us not hold back from these original ideas, basic questions and formative choices.

Where do we start?

A developing country with large masses of poor and excluded people CAN NOT depend on a private led health system. In the sticky web of globalization, public sector leadership can be a literal matter of life and death.

Because most of health supply in Nigeria is private, our Out of Pocket (OPP) payments are among the highest in the world. Donor financing cannot fill the gap. One reason why, is that, for every $1 in aid a developing country receives, over $25 is spent on debt repayment. Donor dependency creates a vicious cycle that actually crowds out public spending on health.

How can we transition away from foreign aid?

In the closing chapters of Global Health in Practice (2022), Dr. Olusoji Adeyi makes stepwise recommendations for pivoting away from foreign aid for health.

We can immediately accept full financial responsibility for the building blocks of health. With better planning, we can budget for essential medicines and basic health services. We can refocus foreign aid toward more complex strategic reforms. This can give us enough time to transition.

The refocused technical assistance can scale up home-grown research networks, think tanks, insurance systems, disease surveillance, manufacturing technology, and integrated health systems. By 2030, our health sector should be locally financed, in line with global consensus on sustainable development.

The assumption itself is not natural - it was indoctrinated through propaganda, colonial education and religious belief. Indoctrinated, so that said co-dwellers can extend neocolonial extraction & capital violence in perpetuity.

With minimum resistance.

But, we just might change our attitude to life, if one day, Africans collectively wake up and confront the truth, that we have been placed on a planet, surrounded by hostile, violent enemies who have been eliminating us steadily for 400 years.

And, that, no one, is coming to save us.

And that, there’s no white heaven in the afterlife to forfeit our earthly responsibilities for.

And that there’s no devil in hell because the devil has been here in our business 400 years long.

And that, we are here in this hostile planet, sitting atop most of its resources, especially energy, which our enemy does not have; and as competition for these critical minerals and other non renewable resources tightens, our better armed co-dwellers are eventually going to need to take us out of the way.

What if we confront these existential truths? Would we maybe start to do things differently?

There is only one thing, not 2, not 3, just one, by which the enemy is superior: violence.

On this one thing Africa must focus, in order to secure a permanent exit from this 400 year rat race. Disrupt, once and for all, this trans generational series of back to back nightmares.

When enslaved Africans were transported coast to coast, naked, on those deep-hulled ships, the only thing that repressed uprisings was not their captors numbers or muscles or beauty or brilliance, but guns.

Fast forward, when President Trump crudely disrupts the colonial celebration of Christmas in Nigeria, it is not with words or intelligence or even money, but bombs.

Weapons are The One Thing.

The one thing white people have that Africans don’t have. And the one thing they have, that we need too.

We don’t need aid. We don’t even need transfer of technology. That’s a stupid idea - it suggests technology stays one place so you have to “transfer” it. Absurd. Wherever humans are, wherever nature is, technology is there. Historically Africa innovated everything, still can, once it deprograms.

Only one thing we need to aspire to: pancontinental military and weapon technology that asserts dominance. Dominance in a world where we have everything, and everyone else wants what we have.

Will it be easy to do? The answer is that we don’t even have a choice. The ease of it is a non question. We are already being eliminated. 2026 will likely see a scaling up of western aggression, indirectly through hostile policy changes, and directly through war.

Africa will not be ready in one year. But we can show that we are clear about the threat facing us. A seed has already matured in the Sahel, and it is small, but it will eventually envelop whatever will be left of Africa, whatever survives the wars of external aggression.

And, just in case anyone hasn’t noticed, the war isn’t coming:

it’s already on our soil.

Still: Africa’s rise is inevitable. Our ancestors who resisted maafa, their enslavement and subsequent colonization, called for this. Not all of us will see this to the end. Many of us will be swept away in it. Our individual experiences don’t count, as much as our collective contribution to what will become New Africa.

Do we want peace & security? Sustainable development? Education? Health? Housing for all? Everything is tied to politics. And to change the politics, Africa also has to challenge the geopolitics. And, the first law of the global political economy is deterrence with the left hand, while building with the right.

As Africa goes, so does the whole planet. Even if they all look the other way now, their own survival on this deadly, now dying planet, depends on Africa. Climate crisis is the planet’s final answer to the unsustainable, imbalanced, violent exploitation of the many to develop the few. When Africa gets back in the driver’s seat, our planet will finally know peace. But, if we want peace, we must be prepared for war.

In countries like Nigeria, most of health supply is in private hands. As a result, Out of Pocket (OPP) payments are among the highest in the world. This is incompatible with development. Because of its dependence on a global logistic chain that is largely foreign to recipient countries, donor financing quickly turns into a vicious cycle that crowds out public spending. Economists call this tight relationship between productivity and health expenditure, the first law of health economics.

For millions of working class poor to survive, one, we have to end donor financing, and two, we have to end the foreign technical advice that leads to donor dependency.

Contrary to donor-supported thinking, for developing countries to get on their feet, their health systems have to be publicly owned, funded, and advised by government & indigenous experts. Perpetual funding without personal responsibility and accountability only breeds spoilt children. Or, as one famous children’s story puts it, if you pay, you dictate.

But: there is a role for the private sector in pharmaceuticals, logistics and services. This economic space must be tightly regulated. In that tight space, the supply chain must be all-local. An import based, and purely for-profit motive will only exclude millions of vulnerable people from the supply of health.

Drug manufacture

For a health system worth the name, we have to do this non-health thing: develop industrial capacity. Drugs, consumables & disposables have to be locally manufactured and in bulk.

We can’t hope to build a health system on drug imports because access will then be limited by end user cost. Local production will help lower end user costs and if scaled up, it will guarantee access and availability. Production will be fully subject to regulation, competitive pricing, innovation, consumer-oriented markets and competitive distribution.

Standardization of quality

Health facilities and service quality must also be standardized. A single, locally sourced standard must be applicable, replicable & regulable, anywhere, nationwide. But then, again, building systems, construction materials and rules of service cannot exist in isolation from generalized poverty. If we have too many poor people, they will be forced to prioritize cheap materials over quality, resulting in a haphazard uncontrolled construction culture. We can’t expect to regulate quality when we can’t determine if those inputs and materials are easily available locally.

Skills & spare parts

We also need to build local capacity for standard-quality construction skills, spare parts and tools for maintenance. In addition to physical, non-imported, local manufacturable or assemblable materials, quality of the workmanship itself, as a type of service delivery, must be set to one single standard. This same standard must be applicable in every facility, no matter where located, in a big city or even the most remote villages.

See? We must not think in silos about health. All this is a development problem, not a health problem, still, it determines health outcomes.

Backward thinking & antiquated systems will persist if we continue to allow foreign technical advisers and donor agents to come to tell us about health quality. Because of their limited budgets, self-interest and geopolitics, they can not afford to go into the necessary detail: that there is a whole-of-government approach, outside of health itself, to build truly independent health systems.

We are always left feeling like moral failures. We learn helplessness and dependency on their drip drop donations, and top-down advice. It takes a holistic, in depth deconstruction of a century of slow or no development, to finally answer why our health systems are still stuck in the stone age, since the stone age. Our aim should be policy meetings without a single foreign technical adviser or donor in the room, where all ministries and agencies regardless of sector, collaborate.

As the economy develops, and each sector is growing, a healthy, secure and insured population will be the result.

In my candid view, it doesn’t matter what percentage of a budget we devote to health. Whatever the number, 5 percent? 10 percent? 15 percent? Take Nigeria for example. Our range of budget percentages is wide - while states like Imo have about 3 percent for health, states like Kano devote about 15 percent.

Yet not one of them is effective in delivering quality health for all.

Productivity first

The real question we should be asking is, what percent of what???

In the Nigerian example, all states are economically non self-sustaining, with an unproductive focus on federal allocations. Relative to our state populations, our economies are tiny. Tiny because, we produce nothing, all 36 of us. We were bottled fed from birth and now 36 old men are still collecting from mummy. Because of this developmental anomaly, our entire state budgets are so insignificant, that any sector budget is inherently a drop in the ocean.

5 percent, 10 percent of nothing, is still nothing.

Think at Scale

The population of the average Nigerian state is the size of several actual countries. Until our economic productivity increases to reflect our population sizes, and our actual economic needs, “meeting the Abuja declaration target” will be both impossible and ineffective.

What then is a practical scale for our health budgets?

Imagine if for example, one Nigerian state can have the same total budget as the Netherlands, a country which has a smaller population than many Nigerian states? Then, 5 to 10 percent of that would be something, wouldn’t it? There’s no Nigerian state that is not more resource endowed than the Netherlands. But there is also no Nigerian state that even one tenth as productive as the Netherlands.

Now, the Netherlands devotes just 10 to 11 percent of its total budget to health. In principle, why can’t Kano state for example, which devotes a whopping 15 percent, have a better health system than the Netherlands?

Because, 15 percent of nothing is still nothing.

Economic productivity is not a major point in most donor technical advise. In fact, donors are more likelyy to say that health will lead to economic productivity, instead the other way around. You already know why: if we start to understand economic productivity, donors will be put out of business.

Let’s answer one quick question: what low-hanging, immediate aspects of economic productivity are key to develop health systems?

Geopolitical Objective of Donors

The primary reason is that aid is designed for the strategic objectives of the donor. This strategy is two-fold. Geopolitical and economic.

Development assistance for health is part of positive signaling within a wider global governance structure. Geopolitical objectives include keeping funded countries psychologically dependent on both financing and foreign technical advice.

As missionaries were to colonization, so is the aid industry to neocolonialism. In each case, the link is never apparent, except in retrospect.

Even when donors are fronted by locals, such as indigenous health sector leaders, researchers or report writers, the practice of donor funding, or Development Assistance for Health (DAH), grew out of a post WW2 colonial objective. It used to be called ‘charity’: a more refined way of maintaining western geopolitical and colonial control, through economic leverage.

Economic leverage includes wider, global levers, such as trade agreements and preconditions for financing that maintain old hierarchies in new ways. One Yorùbá proverb says, “Òkè lọwọ afúnii gbé,” which implies that the giver’s hand remains “on top”.

For this purpose, donors are part of a wider global system which keeps countries that receive funding dependent, by providing just enough financing with one hand, but also imposing conditions, recycling debts, restricting global trade and securing military objectives.

Economic Objective of Donors

Secondly, and equally important is the economic objective. The donor system guarantees a supply chain for manufacture, and global distribution of health products. This economic objective funnels donor money through the global banking system, back to the countries where it was donated from: with profit. Recent research shows aid plays a key role in helping donor countries secure access to critical minerals.

We can agree that the historical and global context of the donor system is fairly complex, and not always obvious at the point of delivery. We can also, clearly see that is not in the interests of donors to permanently solve the problem. If they do, they, their governments, their banks, corporations and other partners will be out of business.

Look no further than the current cold war between the West and China to see the geopolitical and economic reaction to economic competition, or any potential disruption of the global hierarchy that has existed since WW2.

Aid is designed to keep recipient countries coming for more, but still never develop enough to completely exit the cycle. A recent UN report reminds us, in case we forget, that the “C” in the UK’s Foreign, Commonwealth and Development Office (FCDO), originally stood for ‘Colonial’. In 1966, the acronym was, ahem, modernized. If on the other hand we prefer to believe that nearly a century of donor dependence is all about ‘charity’, then, perhaps we are not yet ready to build independent, sustainable health systems?

A recent report, the SBM Health Preparedness Index, published 6th November 2025, assesses the capacity of Nigeria’s 36 states to respond to health emergencies. Its findings show that none reached even 30% preparedness. The report concludes states have fragile health systems.

Low budgets, poor infrastructure, and medical brain drain are the key culprits. The report expects policy to fix these findings.

Useful as it seems, a report like this is still scratching the superficial surface. Its findings, though health-sounding, are actually, non-health issues.

We can’t fix health systems, if we don’t dig deeper: with our own tools. Donor sponsored reports, such as this, cannot provide a harvest of answers.

In fact, they are not designed to.

Donors are limited by design

Outside of their strategic objectives, donors don’t have any dog in this fight. They can’t offer no-strings technical advice, or altruistic financing.

Not their circus, not their monkeys.

Until developing countries ourselves start generating our own original ideas, no thorough analysis of health systems can emerge. Generational cycles of dependence on development assistance for health will persist.

In 2009, Harvard trained, Zambian born economist, Baroness Dambisa Moyo argued that despite a half century and more than $1 trillion, development assistance has not improved the lives of Africans.

Moyo’s radical insight was not well received. Billionaire philanthropist, Bill Gates, said Dambisa Moyo’s book Dead Aid was “promoting evil” and that “she didn’t know much about aid”.

Even pro-poor former World Bank economist Jeffery Sachs denounced Moyo’s views as “cruel and mistaken.”

In a twist on religious fears of the antichrist, the New York Times branded the Zambian economist the “anti-Bono”.

Two decades after Dead Aid, donor envelopes have shrunk, local health spending has not grown, and debt traps have gone through the roof. Many countries are in panic mode.

After nearly a century of dependence on aid and technical advice, why do donors still not have the answer? In the next edition, I will provide 2 reasons why this is by design. We must first challenge our sources of thinking, for Donor Assistance for Health (DAH) to end, and new health systems to begin.

1. The problem of health is not in the health sector.

2. Health is an outcome of other, non-health things.

3. No minister of health can fix health.

4. It stands to reason, that in a developing economy, health cannot be developed unless the other non-health sectors are also moving forward. This is because, although policy sectors are categorized separately, in real life they work side by side, like interlocked gears. The entire national economy is one machine, and health is only one of its moving gears; if other, non-health sectors slow down or are not moving forward, health will also grind to a halt.

Hi. My name is Ayo Adene.

For 25 years, I’ve been working to bring health care to large populations in 50 countries. In this series, I share original insights, outside of hospitals, outside of the usual policy conversations. If you’ve ever wondered why health systems are not working, this is your newsletter.

Some of the answers we will find also apply, not only in health, but in every other sector. We will see that for health itself to develop, we need to tackle economic productivity and broader development. And that this cannot be a secondary consideration at all.

Health is a generational burden. If we don’t grasp these first principles, we will trapped in one more failed cycle. For many developing countries, tasks that take longer than one election cycle, are relegated. To see the results of all the hard work done by several generations of health workers and policy makers, we have to transcend politics itself.

But, health is too important to leave to health workers and politicians alone. This conversation is for everybody.

If you’re ready, type ‘yes’ in the comments below, and let’s go!